High-dose chemotherapy without stem cell transplantation for refractory childhood systemic lupus erythematosus

Chemotherapy
Xue-Qun LuoShu-Mei Chen

Abstract

Intensive chemotherapy followed by autologous hematopoietic stem cell transplantation (ASCT) is effective for refractory systemic lupus erythematosus (SLE). When intensive chemotherapy is immunoablative but nonmyeloablative, ASCT for hematopoietic reconstitution, with the risk of reinfusing autoreactive lymphocytes, is unnecessary. Four children aged 12-16 years were enrolled, 3 with WHO class IV nephritis, 2 with hemolytic anemia and 1 with thrombocytopenia. Median disease duration prior to the study was 4 years (range 1-6). Previous therapy, including intravenous bolus cyclophosphamide (Cy) with a median accumulated dose of 6.5 g/m(2) and high-dose methylprednisolone with a median accumulated dose of 370 mg/kg, had failed. The protocol included: Cy 1.2 g/m(2) daily for 4 days, fludarabine 30 mg/m(2) daily for 4 days, porcine antilymphocyte globulin 25 mg/kg daily for 3 days. Themedian duration of absolute neutrophil count <0.5 x 10(9)/l was 5.5 days after treatment. The median SLE Disease Activity Index and urine protein decreased from 8.5 and 3.4 to 1.0 and 0.1 g/day at the date of last follow-up (median 20 months), respectively. Two cases with hemolytic anemia and 1 with thrombocytopenia before treatment recovered to normal...Continue Reading

Citations

Jul 24, 2010·Clinical and Experimental Nephrology·Mohamed M Sayed-Ahmed
Oct 1, 2010·Saudi Pharmaceutical Journal : SPJ : the Official Publication of the Saudi Pharmaceutical Society·Mohamed M Sayed-Ahmed
Sep 25, 2019·Allergy, Asthma, and Clinical Immunology : Official Journal of the Canadian Society of Allergy and Clinical Immunology·Nipun Lakshitha de Silva, Suranjith L Seneviratne

❮ Previous
Next ❯

Related Concepts

Related Feeds

Blood And Marrow Transplantation

The use of hematopoietic stem cell transplantation or blood and marrow transplantation (bmt) is on the increase worldwide. BMT is used to replace damaged or destroyed bone marrow with healthy bone marrow stem cells. Here is the latest research on bone and marrow transplantation.